Exploring Distrust in the Wait and See: Lessons for Vaccine Communication

Abstract

We conducted in-depth interviews with survey respondents who were distrusting of government authorities and/or communications, and also undecided about accepting the COVID-19 vaccine. Our sample was racially and ethnically diverse, mostly lower income without a college degree. Participants were concerned about their own health and cared about public health, but expressed mistrust in the government and the media. They generally felt ignored by public and institutional systems and expressed a desire to be listened to. These attitudes all influenced lack of confidence in the vaccine. We identify specific opportunities for intervention and communication in vaccine promotion. We propose longer-term solutions for improving trust, which is essential for the effective delivery of future health interventions.

Meta-summaries effective for improving awareness and understanding of COVID-19 vaccine safety research

“…We first conducted qualitative interviews with a co-design component 28 with vaccine-hesitant people in the U.S, in order to learn why they were hesitant to get vaccinated and to have them sketch out ways of accessing scientific knowledge about vaccines. As a method, co-design can help build empathy between researchers/designers and participants/users 29 , an important consideration when eliciting feedback from people hesitant about the COVID-19 vaccines 13 . It also allows us to frame the interviews around participants’ needs, with the intention of establishing buy-in from participants who may not otherwise trust research on Covid-related topics.…”

“…For both versions, we also drew on qualitative work that suggests providing “facts over exhortations” for vaccine-hesitant people 13 . This is in-line with research on psychological reactance 30 , whereby people respond negatively when they perceive that their freedom is being threatened.…”

“…Greater transparency and probity 1 , and communication of “facts over exhortations” 13 , are needed to improve the relationship between a vaccine-hesitant public and vaccine research. To meet this need and communicate much-needed vaccine information, this paper reports on online, interactive meta-summaries of COVID-19 vaccine safety research aimed at increasing public awareness, knowledge, and understanding in a transparent and trustworthy way.…”

What can public health communicators learn from Reddit? A perspective for the next pandemic

“…This may be key to overcoming the siloing between anti-vax and pro-vax networks that occurs on other platforms, allowing messaging to reach a broad range of individuals across the spectrum of vaccine acceptance ( 29 ). Secondly, posts on r/HermanCainAward, taken straight from the source, are not burdened with the level of public distrust that increasingly plagues experts and public health institutions ( 30 ). The message content is produced by members of its target audience and curated by Reddit users to follow a simple narrative format, an example of the participatory approach to public health communication enabled by social media ( 31 ).…”

Examining the relationships between trust in providers and information, mistrust, and COVID-19 vaccine concerns, necessity, and intentions

“…Thus, efforts must not only account for vaccine-relevant perceptions but must be done in tandem with structural efforts to promote access and equity in vaccine distribution. Efforts to a) ensure equity and access and b) not only listen to but also be responsive to community concerns (including, but not limited to those around the vaccine) can serve to not only reduce barriers but also facilitate trust building [76]. As we continue to understand the nuances of the relationships between trust, mistrust, and vaccination necessity, concerns, and beliefs, we cannot lose sight of the environment and context these perceptions are situated within.…”